No long walk to clinics

Idah Clement is a mother of two. Every time her two-year-old asthmatic son was taken ill, she had to walk almost 10 kilometres from Ntasa Village to Kunenekude Health Centre in Mwanza.

The little boy’s condition meant frequent travels and extra costs as bicycle taxi operators charge K1 500 per trip.

“It was costly,” Clement says. “Sometimes, we had to walk. The costs were higher if health workers at Kunenekude referred us to Mwanza District Hospital.”

Senior HSA Everson Mtiwanthu assists a child at Kalioni

Nearby clinics

Clement and her neighbours fom Traditional Authourity (T/A) Nthache rarely go to Kunenekude.

Last August, Save the Children in partnership with the Ministry of Health opened a village clinic at Samu in the neighbouring T/A Kanduku.

The clinic is part of a three-year initiative to reduce deaths and improve the health of under-five children in hard-to-reach parts of Mwanza, Neno, Thyolo and Blantyre.

The partners envisaged no child walking more than five kilometres to get to the nearest health facility.

 “Since August, my son gets treatment from a health surveillance assistant (HSA) stationed at the nearby clinic,” she says.

In T/A Chekucheku, Neno, Galeta villager Margaret Kapherana, recalls days when children in the rural locality were dying on their way to Chiponde Health Centre.

Others died prematurely on the long walks to Neno District Hospital.

“The opening of Kalioni Village Clinic has reversed the trend,” she said, explaining: “Children were the worst affected as cases of malaria were frequent, but long distances made the situation worse.”

When children suffered fever at night, parents had to wait for daybreak to take them to the distant health centre.

“By sunrise, the situation would be worse. Some children died on the way,” says Kapherana.


Improved health

The village clinics give the remote population the ease to swiftly access vital health services just when need arises, whether day or night.

The villagers praise these clinics for saving lives of infants and under-five children.

Jacqueline Emmanuel is happy that Kalioni Village Clinic allows her and other women in the hilly locality to access modern family planning methods right in their village.

Contraceptives in the country are still associated with myths, stigma and discrimination.

Women were afraid of travelling to Chiponde or Neno District Hospital fearing that their spouses and neighbours will know they are on contraceptives.

Neno district medical officer Dr Arnold Jumbe and Mwanza district health officer Raphael Piringu praises of the project to improve essential child health services.

The health officials say health-seeking habits and the uptake of family planning are on the increase.

Interestingly, the number of pregnant women and children dying of treatable conditions are dropping. “With more people seeking health services close to where they live, the health status of Malawians in hard-to-reach pockets of Mwanza has also improved,” says Piringu.

He is delighted the organisation trained HSAs in integrated community case management as well as maternal and newborn care and community mobilisation.

The community health workers now identify and treat malaria, diarrhoea, pneumonia and other uncomplicated cases of common killers of children in the new clinics.

They also identify pregnant women and tell them the importance of attending antenatal and postnatal care as well as delivering at a clinic.


Better outcomes

In Neno, the terrain is mostly hilly and most settlements are far from health centres.

Jumbe commends Save the Children for positioning the village clinics within reach.

“Easy access to medication and family planning methods has not just improved mothers and children’s health status. It has also reduced congestion at the district hospital,” he says.

According to the 2015 Malawi Demographic and Health Survey, 42 babies in every 1 000 die prematurely.

The key indicators also show that only 23 in 1 000 children live to see their 12th birthday.

However, the overall under-five mortality rate is higher-with 64 deaths per 1 000 live births

Save the Children maternal newborn and child health programme manager Luwiza Puleni says this has to change.

“In this project, we believe improved access to community health services, including family planning, could lead to reduced maternal and child mortality and improve overall development indicators within rural areas.” n

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